Individual provider Active NPI

Olubusayo Oluwadamilola Odusanya

  • Marriage & Family Therapist
  • Los Gatos, CA
National Provider Identifier
1033858600
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
404329 Issued in CA
Practice address
499 Loma Alta Ave
Los Gatos, CA 95030-6227
Phone
(877) 722-2737
NPI assigned
Jun 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 404329 CA Primary

Addresses

Primary practice location

499 Loma Alta Ave
Los Gatos, CA 95030-6227

Mailing address

499 Loma Alta Ave
Los Gatos, CA 95030-6227

Other names 1

  • Busayo Odusanya Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
404329CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1033858600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 LOMA ALTA AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950306227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 LOMA ALTA AVE",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950306227",
            "telephone_number": "877-722-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUSANYA",
        "first_name": "OLUBUSAYO",
        "middle_name": "OLUWADAMILOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "404329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BUSAYO",
            "last_name": "ODUSANYA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.